Make a Referral

Use this form to refer an individual to 365 Rehab for workplace rehabilitation, injury management or specialised assessment services. Our team reviews every referral promptly and works with you to ensure the person receives the right support based on their needs and circumstances.

Objective & independent Reports

Informed Decision-Making

Clear Path Forward

Instructions: Complete all relevant fields below. Our team will review your referral and respond within 24 hours.
Referral Type
Pick the one that best matches this referral.
Details of Person Being Referred
Referrer Details
Insurer/Employer Details (if different)
Treating Doctor
Attachments Word document recommended. Most file types supported.
Service(s) Requested
Comments / Additional Information